PACIO Advance Directive Interoperability Implementation Guide
0.1.0 - STU 1 Ballot

PACIO Advance Directive Interoperability Implementation Guide, published by HL7 Patient Empowerment Working Group. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

Resource Profile: Personal Intervention Preference

Defining URL:http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
Version:0.1.0
Name:PADIPersonalInterventionPreference
Title:Personal Intervention Preference
Status:Active as of 12/3/21, 11:52 PM
Definition:

This profile is used to represent a personal preference for a type of medical intervention (treatment) request under certain conditions.

Publisher:HL7 Patient Empowerment Working Group
Source Resource:XML / JSON / Turtle

The official URL for this profile is:

http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference

The Personal Intervention preference represents the patient’s preferences for treatment interventions based on their personal goals and priorities. The patient may indicate whether they wish to issue an advance directive (instruction) to receive intubation, tube feeding, life support, and/or pain management to name a few. The preferences may be documented in narrative form or the result of selecting from a list of options provided by the content creator/implementer. Enabling the patient to state the interventions they want to receive so the care team is aware of those preferences can have a meaningful impact on the ability of the provider to deliver person-centered care that reflects the patient’s values and priorities for treatment.

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from PADIGoal

Summary

Mandatory: 1 element
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element Goal.category is sliced based on the value of value:$this

This structure is derived from PADIGoal

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*PADIGoalDescribes the intended objective(s) for a patient, group or organization
... Slices for category 2..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Slice: Unordered, Open by value:$this
Binding: Intervention Preferences (extensible)
.... category:type S1..1CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: intervention-preference

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal I0..*PADIGoalDescribes the intended objective(s) for a patient, group or organization
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text S1..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣ1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... Slices for category SΣ2..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Slice: Unordered, Open by value:$this
Binding: Intervention Preferences (extensible)
.... category:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..*CodingCode defined by a terminology system
..... text SΣ0..1stringPlain text representation of the concept
.... category:type SΣ1..1CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example): Codes for grouping and sorting goals.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: intervention-preference
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..*CodingCode defined by a terminology system
..... text SΣ0..1stringPlain text representation of the concept
... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): The level of importance associated with a goal.

... description SΣ1..1CodeableConceptCode or text describing goal
Binding: SNOMEDCTClinicalFindings (example): Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used.

.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... padi-contextualValue-extension 0..1(Complex)Contextual Value
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who this goal is intended for
... start[x] Σ0..1When goal pursuit begins
Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.

.... startDatedate
.... startCodeableConceptCodeableConcept
... target SI0..*BackboneElementTarget outcome for the goal
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure SΣI0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

.... detail[x] SΣI0..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1Reach goal on or before
..... dueDatedate S
..... dueDurationDuration
... statusDate Σ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy SΣ1..1Reference(US Core Patient Profile)Who's responsible for creating Goal?
... addresses 0..*Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)Issues addressed by this goal
... note S0..*AnnotationComments about the goal
... outcomeCode 0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example): The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months".


... outcomeReference 0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal I0..*PADIGoalDescribes the intended objective(s) for a patient, group or organization
... text 1..1NarrativeText summary of the resource, for human interpretation
... lifecycleStatus ?!Σ1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... Slices for category Σ2..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Slice: Unordered, Open by value:$this
Binding: Intervention Preferences (extensible)
.... category:All Slices Content/Rules for all slices
..... text Σ0..1stringPlain text representation of the concept
.... category:type Σ1..1CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example): Codes for grouping and sorting goals.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: intervention-preference
..... text Σ0..1stringPlain text representation of the concept
... subject Σ1..1Reference(US Core Patient Profile)Who this goal is intended for
... target I0..*BackboneElementTarget outcome for the goal
.... measure ΣI0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

.... detail[x] ΣI0..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] Σ0..1Reach goal on or before
..... dueDatedate
... expressedBy Σ1..1Reference(US Core Patient Profile)Who's responsible for creating Goal?
... note 0..*AnnotationComments about the goal

doco Documentation for this format

This structure is derived from PADIGoal

Summary

Mandatory: 1 element
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element Goal.category is sliced based on the value of value:$this

Differential View

This structure is derived from PADIGoal

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*PADIGoalDescribes the intended objective(s) for a patient, group or organization
... Slices for category 2..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Slice: Unordered, Open by value:$this
Binding: Intervention Preferences (extensible)
.... category:type S1..1CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: intervention-preference

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal I0..*PADIGoalDescribes the intended objective(s) for a patient, group or organization
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text S1..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣ1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... Slices for category SΣ2..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Slice: Unordered, Open by value:$this
Binding: Intervention Preferences (extensible)
.... category:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..*CodingCode defined by a terminology system
..... text SΣ0..1stringPlain text representation of the concept
.... category:type SΣ1..1CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example): Codes for grouping and sorting goals.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: intervention-preference
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..*CodingCode defined by a terminology system
..... text SΣ0..1stringPlain text representation of the concept
... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): The level of importance associated with a goal.

... description SΣ1..1CodeableConceptCode or text describing goal
Binding: SNOMEDCTClinicalFindings (example): Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used.

.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... padi-contextualValue-extension 0..1(Complex)Contextual Value
URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who this goal is intended for
... start[x] Σ0..1When goal pursuit begins
Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.

.... startDatedate
.... startCodeableConceptCodeableConcept
... target SI0..*BackboneElementTarget outcome for the goal
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure SΣI0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

.... detail[x] SΣI0..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1Reach goal on or before
..... dueDatedate S
..... dueDurationDuration
... statusDate Σ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy SΣ1..1Reference(US Core Patient Profile)Who's responsible for creating Goal?
... addresses 0..*Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)Issues addressed by this goal
... note S0..*AnnotationComments about the goal
... outcomeCode 0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example): The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months".


... outcomeReference 0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
Goal.languagepreferredCommonLanguages
Max Binding: AllLanguages
Goal.lifecycleStatusrequiredGoalLifecycleStatus
Goal.achievementStatuspreferredGoalAchievementStatus
Goal.categoryextensiblePADIInterventionPreferencesVS
Goal.category:typeexamplePattern: intervention-preference
Goal.prioritypreferredGoalPriority
Goal.descriptionexampleSNOMEDCTClinicalFindings
Goal.start[x]exampleGoalStartEvent
Goal.target.measureexampleLOINCCodes
Goal.target.detail[x]example
Goal.outcomeCodeexampleSNOMEDCTClinicalFindings